Supported Decision-Making Service

Supported Decision-Making Service for Persons with Disabilities | Service Model

The Human Rights Center for People with Disabilitis

Using existing models in a bid to identify the will:

The PATH (Planning Alternative Tomorrows with Hope) model assists a person to identify their

wishes. The model consists of nine stages, focusing on a person's dreams and their transformation

into achievable goals and it is mainly aimed at persons with intellectual disabilities. Another model,

known as MAPS (Making Action Plans), was developed in the context of children with special

needs but is also applicable to adults. The model is aimed at assisting a person to build a personal life

story and to identify their wishes based on their life story, dreams and aspirations, fears, significant

past choices, preferences, strengths and skills, resources available to the person, etc.

B. Information

Once the person's basic wishes are identified, updated and relevant information should

be gathered concerning the available options, enabling them to weigh the advantages

and disadvantages of each option towards making a specific decision. The supporter

does not have to be a content expert and should not provide the information to the person, but

rather help them access and understand it.

Practical tools:

• Rely on the supported person's knowledge.

• Suggest sources that can provide information.

• Hold joint meetings or conversations with professionals, service providers, experts,

and (obviously) family members and friends.

• Explore ways to overcome internal impediments (language, communication difficulties)

and external obstacles (bureaucracy) to accessing information.

• Illustrate the information to the person (using a chart, a drawing, other visual aids).

• Simplify and reorganize the information (important and unimportant, more or less

relevant).

• Synchronize information obtained from different sources.

C. Options

A person almost always has more than one option. The decision-making process

consists of identifying the different options and understanding the advantages and

disadvantages of each one of them. This is the core of the support outline and it is its

most sensitive stage, given that biased support can easily highlight the disadvantages of one

option and the advantages of another in order to lead the person towards a certain choice. This is

where the supporter's professionalism and personal ethics come into play: the supporter’s role is

to put themselves aside as much as possible and help the person identify the different options

available to them. Still, there is value in the supporter taking a proactive approach at this stage,

raising additional options which were not considered by the person and pointing out advantages

and disadvantages which had not been taken into account. It is also important to encourage the

person to consult with the people close to them to hear their opinion about the different options.

At this point the supporter may face the dilemma of whether to share their personal position with

the person (see

for discussion of the ethical dilemmas that came up during the pilot).